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Printable Form 9325 Hayward California: What You Should Know
Medicaid) to determine eligibility. If you are currently receiving services from DCF or a state child support agency, contact them before you begin the application process to establish your eligibility to receive services in Florida. If you are a recipient of SSI, we need you to sign the Affidavit of Support (Form DS-10) which will allow us to determine your eligibility. If you are applying for permanent SSI benefits, you need to fill out two forms: First, you will need to sign and date the Affidavit of Support, and give it to Social Security about ten days prior to the submission date for your first claim for SSI. We will send you a new Affidavit of Support, along with a Social Security number for you to sign. Once you receive your Social Security number, fill out our Form SS-5 and send it to SF. This form states your current SSI amount, and you are expected to follow the instructions. Once we have received the Affidavit of Support, we will e-mail you confirmation for the Affidavit and SSI benefits. SSI applicants will also need to supply medical records for both parents, including the parent's medical prescription and any related medical and psychiatric history. The parent must sign the medical records. All medical records must be dated within the last three years, and must show the parent's name and address along with the parent's last two Social Security cards. If you are under 18 years of age, the father must sign the medical records and provide his signature for any child support payments that may be due to DCF. We do not accept requests for a waiver of this age requirement. The father will also be signed off on any Medicaid payments that may be due to SC For SSI. Again, if you are under 18 years of age, the father must sign the medical records. All medical records must be dated within the last three years, and must show the father's and the mother's names. If you do not have the above information, contact Social Security at for further assistance, to ensure you have the required information. You must complete the Affidavit of Support within thirty (30) days from the date we have received the records, and submit it with copies of all medical and related records. You will receive an e-mail confirmation for your Affidavit and all records that have to be submitted within this time frame.
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